MONDAY, Sept. 22, 2014 (HealthDay News) -- Five recommended health behaviors may prevent four out of five heart attacks in men, a new study suggests.

Middle-aged and older men were much less likely to have heart attacks over an average of 11 years if they drank moderately, didn't smoke and did everything right on the diet, exercise and weight fronts, the study found.

Only about 1 percent of men involved in the study fit into this ultra-healthy-living category. But they were 86 percent less likely to have heart attacks than those who ate poorly, were overweight, exercised too little, smoked and drank too much alcohol, the researchers said.

The healthiest men could still eventually die of a heart attack, of course, and the study didn't say if they live longer than others.

Still, "there is a lot to gain and money to be saved if people had a healthier lifestyle," said study lead author Agneta Akesson, an associate professor with the Institute of Environmental Medicine at Karolinska Institute in Solna, Sweden.

Akesson's team wanted to gain insight into the combined effect of different aspects of healthy living. Few studies have examined the overall impact in this manner, Akesson said.

For the study, published Sept. 22 in the Journal of the American College of Cardiology, the researchers examined medical records and surveys of more than 20,700 Swedish men who were 45 to 79 years old in 1997. At the time, they had no history of cancer, heart disease, diabetes, high blood pressure or high cholesterol. The researchers tracked them until 2009 to see how they fared.

Eight percent of the men -- 1,724 -- did not practice any of the five healthy behaviors, and 166 of that group wound up suffering heart attacks.
Of the 1 percent of men -- 212 -- who practiced all five healthy behaviors, only three had heart attacks.

Based on their findings, the researchers concluded that all five healthy behaviors together could prevent 79 percent of first heart attacks in men.

Also, each behavior by itself reduced the risk for heart attack. For example, eating a diet rich in beneficial foods such as fruits, vegetables, nuts, reduced-fat dairy and whole grains was associated with a nearly 20 percent lower risk compared to those who practiced none of the healthy behaviors, the study found.

The study has limitations. It doesn't look at how long the men lived. Nor does it offer insight into ethnic minorities, since most of the men in the study were white.

As for women, Akesson is the co-author of a previous study suggesting healthy living has a similar effect on females.

Akesson said the study suggests that men should aim to change their behavior in all five areas analyzed in the study. They can eat better, lose weight, exercise (the healthiest men cycled or walked at least 40 minutes a day), stop smoking and drink only moderately, which was defined as about one drink a day.

One expert said the findings are a good reminder that the benefits of healthy behaviors add up.

"People looking for a magic pill or a modern new technology to prevent heart disease need to be reminded how important lifestyle factors are," said Dr. R. Curtis Ellison, professor of medicine and public health at Boston University School of Medicine.

Ellison praised the study and added that men shouldn't be cavalier about the risk of a heart attack in an era of great medical advances. "It is uncommon for people to die from a first heart attack these days. However, these people are more likely to have future heart trouble," he said.

"Preventing the first heart attack leads to a longer number of healthy years and lower risk of disability as someone ages," Ellison said.